Panic attacks involve the sudden development of fear, anxiety or extreme discomfort accompanied by additional symptoms. They may occur sporadically or as part of an anxiety disorder, such as panic disorder, social anxiety disorder or phobias.

Jordan W. Smoller, M.D., Sc.D., of Massachusetts General Hospital, Boston, and colleagues studied 3,369 healthy postmenopausal women (age 51 to 83, average age 65.9). When they entered the study between 1997 and 2000, the women filled out a questionnaire about the occurrence of panic attacks in the previous six months. They were then followed for an average of 5.3 years to see whether they had a heart attack or stroke or died from any cause.

About ten percent of the women reported having a full-blown panic attack in the six months prior to the study. After the researchers adjusted for other cardiovascular risk factors, having one or more panic attacks was associated with four times the risk of myocardial infarction, three times the risk of having a heart attack or stroke and nearly twice the risk of death from any cause. These associations remained after controlling for depression, suggesting that panic attacks may be a separate, independent risk factor for cardiovascular events.

The results add panic attacks to the list of emotions and psychiatric symptoms that have already been linked to cardiovascular risk, including depression, anger and hostility, the authors note. Panic attacks could be associated with other cardiovascular risk factors, such as hypertension. Alternatively, anxiety could contribute to adverse cardiovascular effects, such as coronary artery spasm, tendency toward increased blood clotting or disturbances in heart rhythm.

“These results suggest that panic anxiety is a marker for increased risk of cardiovascular morbidity and mortality among postmenopausal women,” the authors of the study conclude.